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Individual

KIMBERLY N SPIVEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
51 11TH AVE, AYNOR, SC 29511-3249
(843) 358-3700
(843) 358-3707
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
17728 APRN
SC
363LF0000X
Family Nurse Practitioner
Primary
17728
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP2021
SC
Enumeration date
02/22/2012
Last updated
02/24/2023
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